The main aim of the Psychiatric Proficiency Committee is, i) to determine the educational standards of psychiatric specialization and post-specialization, and to undertake studies with the purpose of elevating the standard; ii) to ensure psychiatric specialist education is provided at the standards determined and undertake studies that enable coordination to be established among educational institutions with the purpose of elevating the quality of such education; iii) to encourage, support and evaluate psychiatric specialists in their participation of continuing medical education (CME) in order to develop their knowledge and application skills.

The Psychiatric Proficiency Committee realizes its aim by defining the application terms regarding a country-wide central and standard exam oriented toward psychiatric specialists, to hold exams at regular intervals, and by granting Certificate of Competency to those who succeed in the exams.

Work Principles

Article 3- The work principles of the Psychiatric Proficiency Committee comply with Specialization By-law in Medicine, the Turkish Medical Association – Specialization Associations Coordination Committee (TTB-UDEK) Directive and TPD Directive. When any amendments take place in Specialization By-law, TTB-UDEK Directive or TPD Directive, the said compliance is sustained in a manner allowing mutual interaction. It pursues compliance with European Union Medical Specialists (Union Europeen des Medecins Specialistes-UEMS) principles.

Article 5- The structure of the Psychiatric Proficiency Committee consists of the following members:

Proficiency General Assembly

Executive Council of Proficiency

Accreditation Sub-Committee

Educational Programs Development Sub-Committee

Proficiency Exam Sub-Committee

Proficiency General Assembly

Article 6- The Proficiency General Assembly:

is the main decision-making member of the Proficiency Committee;

consists of TPD members holding Proficiency Certificates;

convenes at the National Psychiatry Congress bi-annually;

elects eight full and eight alternate members of the Executive Committee of Proficiency and three full and three alternate members of Accreditation Sub-Committee at the bi-annual meeting of the Proficiency General Assembly.

Duties of the Proficiency General Assembly

Article 7- The duties of the Proficiency General Assembly are as follows:

to determine the fundamental principles and necessary operating rules for the realization of the aims of the TPD Psychiatry Proficiency Committee;

to select the full and alternate members of the Proficiency General Assembly through elections for a period of two years;

to assess and exonerate the works of the Executive Council of Proficiency, to provide recommendations, and to take the necessary decisions;

to select the three members of the Accreditation Sub-Committee.

Extraordinary Proficiency General Assembly

Article 8- The Extraordinary Proficiency General Assembly:
It shall convene upon the call of the TPD Central Executive Committee and at the date and with the agenda to be determined by the same within three months after the conditions defined in the following situations occur:

in case the Executive Council of Proficiency deems it necessary;

in case more than half of the total of full and alternate members leave their duties;

upon the joint application of a minimum of one fifth of the members of the Proficiency General Assembly, which has most recently convened.

Executive Committee of Proficiency

Article 9- The Executive Committee of Proficiency:

consists of a total of nine full and nine alternate members, of which eight full and eight alternate members are elected by the Proficiency General Assembly and one full and one alternate member are elected by the TPD Central Executive Committee.

It selects a chairperson, a deputy chairperson and a secretary from among its members in the first meeting it holds after being elected.

Central Executive Committee members, excluding those set forth in paragraph (a) and who shall be selected by the Central Executive Committee may neither be candidates nor be nominated for the Executive Committee of Proficiency;

The Executive Committee of Proficiency is selected from among the members of the Proficiency General Assembly. It is compulsory that those who are going to be candidates should have been working as instructors in an education institute for a minimum of five years, or else be actively involved in institutional education activities for a minimum of five years.

The membership of a member who misses two consecutive meetings without presenting a written excuse for non-attendance, shall cease and the alternate members will be called to duty in accordance with the sequence determined at the election and according to the reduced number.

Duties of Executive Committee of Proficiency

Article 10- The duties of the Executive Committee of Proficiency are as follows:

to regulate the works of Psychiatry Proficiency Committee, to execute the decisions taken and to monitor appointments;

to appoint three members of Accreditation Sub-Committee, Training Programs Development Sub-Committee and Proficiency Exam Sub-Committee from within itself, and to appoint four members of Training Programs Development Sub-Committee, and Proficiency Exam Sub-Committee from outside of the Committee;

to ensure and monitor the works of proficiency sub-committees, and to regulate their functions, to call them to a meeting when required, and to remove from office the members it has appointed when required;

to establish relations with educational institutions and perform the improvement of training studies in line with the report drafted by Training Programs Development Sub-Committee;

to undertake the necessary works in order for the Specialization Training Record Certificate (Assistant Card) prepared by the Training Programs Development Sub-Committee to be applied in Educational Institutions;

to discuss the subjects regarding exam management, principles and application, which are within the definition of duty of the Proficiency Exam Sub-Committee, and decide on such;

if the conditions are suitable, to cooperate with OSYM or similar establishment for Proficiency Written Exams;

to determine the dates of the exams, exams entry fees and to announce such at least six months in advance; to approve the list of those taking the exam; to inform attendants of the exam results; and to reside over and resolve the objections regarding the exams;

to submit a study report on the Proficiency General Assembly;

to undertake the decisions taken in the Proficiency General Assembly;

to define the subject of the study and form the Consultancy Sub-Committees with the purpose of procuring consultancy services without taking into consideration whether such parties are members of the Proficiency General Assembly or not;

to apply to the TPD Central Executive Committee for the purpose of calling meetings of the Extraordinary Proficiency General Assembly, when required;

it is responsible to the Proficiency General Assembly.

Accreditation Sub-Committee

Article 11- The Accreditation Sub-Committee:

consists of three full and three alternate members selected from members of training staff with a minimum of five years experience in institutions that provide specialization training given by the Proficiency General Assembly, three members selected by the Executive Committee of Proficiency from among itself, and three full and three alternate members determined by the Education Supreme Board, totaling nine members.

Sub-Committee members are elected on a bi-annual basis. Terms of duty of the sub-committee members are, at the most, two terms.

The sub-committee elects a chairperson and a reporter from among its members.

The membership of a member who misses two consecutive meetings without presenting a written excuse for non-attendance shall cease, and the alternate members will be called to duty in accordance with the sequence determined at the election and according to the reduced number.

Duties of Accreditation Sub-Committee

Article 12- The Duties of the Accreditation Sub-Committee are as follows:

to establish an accreditation mechanism executed mainly for visitation programs and based on the volunteering of units providing education for the application and continuous improvement of the National Psychiatric Specialization Education Program Approved at the Executive Committee and Proficiency General Assembly at all education units and for its continuous development. It undertakes the updating of studies and forms guidelines, evaluation forms, surveys and standards for accreditation in the following subjects:

to determine whether there exists an education program which is compliant with the proposed education program (purpose and targets of the education program and its effectiveness in realizing these, whether targets in the specialization field – knowledge, competence, attitude and behavior – are clearly defined as measurable behaviors, and whether gains of the specialist student are at the expected level), and to establish whether such a program is being applied regularly;

sufficiency and suitability of the infrastructure (from the perspective of health services and education);

number and competence of the educational and medical personnel;

volume and diversity of the service, whether the health service provision is organized and systematic;

whether research facilities are available and whether education fields participate sufficiently in such activities;

visits, evaluates, determines deficiencies, and develops proposals for overcoming such by visiting the educational institutes within the framework of the standards set forth above;

carries out audits to assess whether education and application activities are being recorded in detail and on time, and specifies these in its accreditation report. Monitors both quantitatively and qualitatively the competencies applied within the process through assistant cards and/or education files (portfolios), and evaluates these in the accreditation report;

audits all the written and oral application exams given to specialist students during their training, and at the end of their specialist education, to measure and assess their knowledge, attitude, competence and performance, and instruct observations-opinions-assessments within the process, and process assessments such as assistant cards; to work in coordination with the Training Programs Development Sub-Committee in the regulation and organization of education processes in conclusion of this assessment; and provides information to the Executive Committee of Proficiency;

and it submits an accreditation report, which contains the headings set forth above, to the Executive Committee of Proficiency in order to ensure the accreditation of the educational institutions following each visit.

Training Programs Development Sub-Committee

Article 13- The Training Programs Development Sub-Committee:

consists of seven members, who have been in an active trainer position for a minimum of five years in an institution that provides specialization education, who are elected by the Executive Committee of Proficiency, and a full and alternate representative of TPD Assistant Commission.

Sub-Committee members are elected on a bi-annual basis. The term of duty of the sub-committee is limited with the term of duty of the Executive Committee of Proficiency.

Sub-Committee members elect a chairperson and a secretary from among themselves.

The membership of a member who misses two consecutive meetings, without presenting a written excuse for non-attendance, shall cease. The Executive Committee of Proficiency realizes the new member appointments.

It convenes at least twice on an annual basis and also by the call of the Executive Committee of Proficiency, when required, and submits a report containing its annual evaluations and study programs to the Executive Committee of Proficiency.

It is responsible to the Executive Committee of Proficiency.

Duties of Training Programs Development Sub-Committee

Article 14- The duties of the Training Programs Sub-Committee are as follows:

it determines the Psychiatric Specialization Training Program in a manner to include the sub-titles given in the below clauses, and makes recommendations to the Executive Committee of Proficiency for the implementation of such at the Education Institutions:

targets and rationale of the training program (general and special targets – knowledge, competency and attitude);

method of applying the training program (such as the terms, rotations, trainers, and committees);

method of testing of the training program (such as interim exams, specialist exams, written-oral exams, form of exam, proficiency measures);

evaluation method of training program at institutions, where training is provided (such as feedback, curriculum analysis, and process evaluation);

it may form sub-groups by consulting the Executive Committee of Proficiency, when required;

it convenes on at least a bi-annual basis, and also by the call of the Executive Committee of Proficiency, when required, and submits a report containing its annual evaluations and study programs to the Executive Committee of Proficiency;

it is responsible to the Executive Committee of Proficiency.

Proficiency Exam Sub-Committee

Article 15- Proficiency Exam Sub-Committee:

consists of seven members to be elected from among those Executive Committee of Proficiency members (i) who are not members of the TPD Central Executive Committee, and who have been working as trainers for a minimum of five years in an educational institution, or have been actively participating in institutional training activities for a minimum of five years and who are professors, associate professors, chiefs of clinics, or assistant chiefs of clinics, (ii) who have obtained sufficient CME credits, which are determined by the Executive Committee of Proficiency in CME activities in the field of psychiatry credited by an international credit institution, whose validity has been accepted within the last five years by the TTB-CME Credit Committee or the Executive Committee of Proficiency, (iii) those with publications at national and international publishing standards to be determined by the Executive Committee of Proficiency. The completion of a training skills course and/or exam measurement assessment course is a reason of preference in the election of members of the Exam Sub-Committee.

Sub-Committee members are elected on a bi-annual basis. The term of duty of the sub-committee is limited with the term of duty of the Executive Committee of Proficiency.

Sub-Committee members elect a chairperson and a secretary from among themselves.

The membership of a member, who misses two consecutive meetings without presenting a written excuse for non-attendance, shall cease. The Executive Committee of Proficiency realizes the new member appointments.

It convenes at least twice on an annual basis and also by the call of the Executive Committee of Proficiency, when required, and submits the report containing its annual evaluations and study programs to the Executive Committee of Proficiency.

It is responsible to the Executive Committee of Proficiency.

Duties of Proficiency Exam Sub-Committee

Article 16- The duties of the Proficiency Exam Sub-Committee are as follows:

to submit to the Executive Committee of Proficiency its report regarding method and principles of the proficiency Exam;

to collect questions that take fundamental and up-to-date information in the field of psychiatry from educational institutions throughout the country for Proficiency Written Exams; to form a question databank; to update it annually; to safeguard the question databank and ensure its security; and to select the exam questions from the question databank;

to realize Proficiency Written Exams; to cooperate with OSYM or a similar establishment for the Proficiency Written Exams, if need be;

to form an exam jury for the Proficiency Application Exam and propose this to the Executive Committee of Proficiency;

to ensure that written and application exams are conducted and evaluated according to the principles of confidentiality and objectivity;

to notify the Executive Committee of Proficiency with regards to exam results;

to ensure that exam results are kept.

Education Supreme Board

Article 17- The Education Supreme Board:

consists of the head of the departments of Psychiatry at Medical Faculties of Universities, and chiefs of training units at Training and Research Hospitals of the Ministry of Health.

Duties of Education Supreme Board

Article 18- The duties of Education Supreme Board are as follows:

elects from among itself the three full and three alternate members of the Accreditation Sub-Committee;

acts as consultant to the Executive Committee of Proficiency in all matters;

shows efforts to enable the application of decisions taken by the Committee and Sub-Committees in the units during the specialist education;

provides feedback about issues that arise in application, and proposes solutions for these issues;

is called to meetings on at least a bi-annual basis in line with the requirements of the Executive Committee of Proficiency.

SPECIALTY AND TRAINING

Specialization

Article 19- Psychiatry specialization covers the principal branch of medicine defined as Mental Health and Diseases Specialization in the Specialist By-Law of Medicine of the Ministry of Health.

Specialization Training

Article 20- The term of the psychiatry specialization training and rotations to be performed and their terms are determined by the Specialist By-Law in Medicine. The content of the education is defined with the worldwide scientific and objective knowledge of the field of psychiatric science.

CERTIFICATION OF EDUCATION

Certification of Specialist Education

Article 21- In order for a psychiatric specialist to enter the exam defined in Article 22, he/she has to apply with a petition to the TPD Proficiency Committee and should attach the following documents to the said petition:

certificate attesting to the fact that he/she may practice as a Psychiatric Specialist in Turkey;

in the case of an assistant card has been applied for during his/her assistantship, a copy of this card, certified by the institution, where he/she acted as an assistant.

EXAMS

Proficiency Exams

Article 22- Proficiency Exams performed on the basis of volunteering are realized in the following manner:

the form and date of the exam is announced upon the recommendation of the Proficiency Exam Sub-Committee and the decision of Executive Committee of Proficiency;

the certificates specified in Article 21 in relation to the specialist education need to have been completed in order to sit for the Proficiency Exam;

the Proficiency Exam Sub-Committee evaluates the applications of candidates, who have applied to sit for the Proficiency Exam, and inspects the specialist education certificates specified in Article 21, and submits the list of those eligible to Executive Committee of Proficiency;

the exam is held in two stages as Written Exam and Application Exam;

exam results are announced to the persons who have taken the exam by the Executive Committee of Proficiency; a Proficiency Certificate is awarded to those who are successful in the exam;

it is a prerequisite to obtain the Proficiency Certificate in Psychiatry principal branch in order to enter for proficiency in side branches defined in Specialist By-Law of Medicine.

Written Exam

Article 23- The principles regarding the Written Exam are as follows:

This is an exam oriented towards measuring the basic and up-to-date psychiatric knowledge of the candidate.

It is held at least once a year.

All candidates, who have fulfilled the terms set forth in Article 21, and those who have become specialists in the principal branch of psychiatry, as well as final year assistants may participate in this exam.

If unsuccessful, CME credits in the amount determined by the Executive Committee of Proficiency should be obtained within the last two years from CME activities in the field of psychiatry credited by an international credit institution whose validity has been accepted by TTB-CME Credit Committee or the Executive Committee of Proficiency in order to retake the exam.

Application Exam

Article 24- The principles regarding Application Exam are as follows:

This is an exam oriented towards measuring the knowledge and clinical competence of the candidate.

Only those successful in the Written Exam may participate in the Application Exam.

It is held at least once a year.

An Application Exam is given by the jury or juries that will be formed by the Proficiency Exam Sub-Committee.

In order to apply for the Application Exam, a period exceeding three years should not have elapsed as of the date of the Written Exam in which the candidate was successful.

If unsuccessful, in order to retake the exam, CME credits in the amount determined by the Executive Committee of Proficiency should be obtained within the last two years from CME activities in the field of psychiatry credited by an international credit institution, whose validity has been accepted by TTB-CME Credit Committee or the Executive Committee of Proficiency.

Certification of Proficiency

Article 25- The principles regarding Certification of Proficiency are as follows:

Certification of Proficiency is awarded to those who have been successful in both of the phases of the Proficiency Exam.

The validity period of the Proficiency Certificate is ten years.

Re-Certification

Article 26- The principles regarding re-certification are as follows:
In order to renew the Proficiency Certification: CME credits in the amount determined by the Executive Committee of Proficiency should be obtained within the last ten years from CME activities in the field of psychiatry credited by an international credit institution whose validity has been accepted by TTB-CME Credit Committee or the Executive Committee of Proficiency. At least half of the CME credits should have been obtained during the last five years.

SPECIAL CASES

Article 27- Persons who complete Psychiatric Specialization Education in a foreign country, and who become eligible to take the Psychiatry Proficiency Exam of the said country, may take the TPD Psychiatry Proficiency Exam, provided they document that they fully satisfy the necessary conditions for entry. The conditions sought and the rules to be followed with respect to such persons are determined and announced by the Executive Committee of Proficiency.

Article 28- In case psychiatric specialists in Turkey sit for a Psychiatric Proficiency Exam accepted by European Medical Specialists Association or by the USA, the awarded Psychiatry Proficiency Certificate shall be deemed to be equivalent to the Psychiatry Proficiency Certificate received in our country.

Article 29- Those who are disqualified from the profession for life are not accepted into Proficiency Exams, and in case they have taken it previously, their Proficiency Certificates will be cancelled.

ENTRY INTO FORCE Article 30- This by-law shall become effective on the date of 8 November, 2003.

From among the members of the TPD General Assembly, where this by-law is voted and accepted, eight persons satisfying the conditions for election and one person from TPD Central Executive Committee shall be elected to the Provisional Executive Committee of Proficiency.

The term of office of the Provisional Executive Committee of Proficiency will be for a maximum of one year.

to accept the applications defined in Provisional Article 3 (a) paragraph, and to grant Proficiency Certificate to those who are suitable;

to perform the necessary arrangements for the convening of the Proficiency General Assembly at the end of the one year term and to apply to the Central Executive Committee.

Provisional Article 3-

In order to obtain a Certificate of Proficiency without an exam, the following conditions are sought: (i) being a professor, associate professor, chief of clinic, or assistant chief of clinic, (ii) having obtained CME credits in the amount determined by the Executive Committee of Proficiency, obtained within the last five years from CME activities in the field of psychiatry credited by an international credit institution whose validity has been accepted by TTB-CME Credit Committee or the Executive Committee of Proficiency, (iii) have published publications in the amount and quality to be determined by the Provisional Executive Committee of Proficiency. Those who satisfy the above conditions are granted a Certificate of Proficiency without any exams being held within two years from the date the by-law is accepted, to be issued by the Provisional Executive Committee of Proficiency within the first year, and to be issued by the Executive Committee of Proficiency within the second year, provided they apply to the relevant Committees with the necessary documents. The phrase “Issued without an exam” shall be inscribed on Certificates of Proficiency granted in this manner.

The validity of the Certificate of Proficiency obtained in such a manner is five years, and in order to obtain a renewed Certificate of Proficiency at the end of the said five-year term, the person has to be successful in the Proficiency Exam.

The validity of this provisional article is for two years, as of the date the by-law enters into effect.

Provisional Article 4-
Proficiency General Assembly convenes with the participation of the members awarded Certificate of Proficiency in accordance with the terms set forth in Provisional Article 3 and Article 28. The Proficiency Exams are held within one year following the convening of the Proficiency General Assembly and the formation of the Committee and sub-committees specified in the by-law.

Provisional Article 5-
Those with Proficiency Certificates without an exam may participate in the Proficiency Committee and sub-committees and assume duties in this Committee and sub-committees for a period of five years, starting as of the Proficiency General Assembly to be held in the year 2009. Proficiency Certificates granted without an exam may not be used for any other purpose than to assume duties in these Committees.